ÛÛÛÛÛÛ»  ÛÛÛÛÛÛÛÛ» ÛÛ»      ÛÛÛÛÛÛÛ»
           ÛÛÉÍÍÛÛ» ÈÍÍÛÛÉÍͼ ÛÛº      ÛÛÉÍÍÍͼ    Basic Trauma Life Support
           ÛÛÛÛÛÛɼ    ÛÛº    ÛÛº      ÛÛÛÛÛÛÛ»
           ÛÛÉÍÍÛÛ»    ÛÛº    ÛÛº      ÈÍÍÍÍÛÛº    REGISTRATION FORM
           ÛÛÛÛÛÛɼ    ÛÛº    ÛÛÛÛÛÛÛ» ÛÛÛÛÛÛÛº
           ÈÍÍÍÍͼ     Èͼ    ÈÍÍÍÍÍͼ ÈÍÍÍÍÍͼ
                                 by KA_Soft (R)

B-BTLS ... Basic BTLS Course Study Program .............. 250 Questions
A-BTLS ... Advanced BTLS Course Study Program ........... 250 Questions

FOR A TOTAL OF ........................................ - 500 Questions

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COST OF REGISTRATION SINGLE USER = $10.00
SITE LICENSE                     = Please see documentation in this packet.

ADVANTAGES TO REGISTERING KA_SOFT EMS SOFTWARE:

        1.  Free Updates if downloaded from my BBS.
        2.  Low $5.00 handling fee if mailed via postal service or internet.
        3.  Free limited-time access to Newberry BBS (30 min per day).
        4.  50% discount from regular price for extended access to the BBS.
        5.  Removal of the UNREGISTERED SHAREWARE nag, and replacement with
            REGISTERED TO [YOUR NAME HERE].
        6.  The warm, fuzzy, feeling that comes with registering the software
            that you use.

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SITE LICENSE:

All corporate, business, government or other commercial, public, or private
users of KA_Soft Shareware must be licensed.  We offer quantity discounts as
well as site licensing.  Please see BTLS.DOC for further information on site
licensing.

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        Remit to:       Ken Anderson
                        PO Box #1928
                        Los Fresnos, Tx  78566-1928

Quantity:       Description:                      Cost:           Amount:

                BASIC TRAUMA LIFE SUPPORT STUDY PROGRAM
                  - B-BTLS - Basic Course
                  - A-BTLS - Advanced Course

________        REGISTER ALL ABOVE FOR:           $10.00        ___________

                         Shipping Charges:      $Free if downloaded from BBS.
                         By US Mail:              $ 5.00        ___________

                         TOTAL: ......................          ___________


Payment:  Please send payment by check or money order.
          I cannot be responsible for cash sent by mail.


NAME:      __________________________________________________________________

COMPANY:   __________________________________________________________________

ADDRESS:   ________________________________________
           ________________________________________
           ________________________________________

WORK PHONE: (    ) ____-______          HOME PHONE: (    ) ____-______

THE FOLLOWING INFORMATION IS
NEEDED IF YOU WISH US TO SET
YOU UP WITH AN ACCOUNT ON OUR
SUPPORT BBS:

LOG-IN NAME: ___________________   ____________________________
                   first                      last

ALIAS:       _________________________________
                        optional

PASSWORD:    ______________________________________________
             must be at least 4 but less than 16 characters


COMMENTS:  __________________________________________________________________
           __________________________________________________________________

-------------------------------End Registration------------------------------